2022 Fiscal Year Final Research Report
Effect of the Pulsatile Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome -comparison of nonpulsatile ECMO-
| Project/Area Number |
19K09407
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Nippon Bunri University (2020-2022)
Junshin Gakuen University (2019) |
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Principal Investigator |
ITOH Hideshi 日本文理大学, 工学部, 教授 (50711462)
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| Co-Investigator(Kenkyū-buntansha) |
市場 晋吾 東京女子医科大学, 医学部, 教授 (30284102)
岡原 重幸 純真学園大学, 医療工学科, 准教授 (50771185)
小畑 秀明 岡山理科大学, 工学部, 准教授 (60437118)
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| Project Period (FY) |
2019-04-01 – 2023-03-31
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| Keywords | ECMO / 重症呼吸不全 / 拍動流 / 定常流 / RV-PA / ARDS |
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| Outline of Final Research Achievements |
The golden standard of veno-venous ECMO with continuous flow for Acute Respiratory Distress Syndrome. This study aimed to investigate the impact of the right ventricle on pulmonary artery extracorporeal membrane oxygenation (RV-PA ECMO) for acute respiratory dysfunction with/ or without pulsatile flow during the RV-PA ECMO. We used the bronchoalveolar lavage procedure with intrapulmonary administration of warm saline to establish a severe acute respiratory distress syndrome model. The observation of pneumocytes clearly showed less pulmonary edema, pulmonary fibrosis, and inflammation after the RV-PA ECMO treatment. The concentration of IL-6 was less in the pulsatile group than in the non-pulsatile group. Our study demonstrated that the pulsatile RV-PA ECMO was less vasoconstrictive and supplied more effective oxygenated pulmonary flow than the non-pulsatile RV-PA ECMO. The pulsatile RV-PA ECMO ameliorates pulmonary circulation and facilitate recovery from acute respiratory failure.
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| Free Research Field |
救急医学
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| Academic Significance and Societal Importance of the Research Achievements |
本研究結果より、RV-PA ECMOを導入することで従来からあるV-V ECMO(右心房脱血・送血)よりも高効率的に酸素加血を傷害肺へ送ることができる。さらに、拍動流を付加させたRV-PA ECMOを用いることで右心室の過負荷を軽減でき、拍動による肺動脈血管内皮及び肺の毛細血管への刺激によって、肺の炎症を抑制できるだけでなく肺血管抵抗を減少させ、肺血流の増加を得ることができることが判明した。このことから、本研究にある拍動流 RV-PA ECMOは重症呼吸不全の肺機能改善効果が明らかになり、重症呼吸不全に対する治療効果と生存退院向上に寄与することが期待される。
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